Regional implementation of Enterprise Document Sharing (XDS)

Background Information

It is widely recognised that the current medical records system, using paper for medical records, has limitations, and that an electronic system could lead to better patient care. This has been achieved for certain clinical areas such as GP systems, laboratory results and radiological reports, but little real-life progress has been made in wider clinical practice, largely due to lack of agreement on how such clinical data should be stored and transmitted.

IHE Cross Enterprise Document Sharing (XDS) attempts to overcome these implementation problems and differs from previous approaches by making a logical separation between the indexing information (the meta-data) and the actual content. This allows XDS to support a wide range of documents, yet still have a simple and consistent method to store, index, locate and retrieve them for clinical use. The separation greatly simplifies the addition of an XDS export function to existing systems, allowing them to use existing output formats such as CDA, PDF and even simple text documents, as well as DICOM and JPEG Images. XDS deliberately allows the use of unstructured formats in order to allow systems to become clinically useful as soon as possible, whilst not precluding an easy progression to more structured data in the future.

XDS has been defined by Integrating the Healthcare Enterprise (IHE), a not-for-profit international organisation, which publishes technical specifications, and organises annual test sessions called “connectathons” where vendors show that their systems can properly communicate and interoperate with at least three other vendors’ systems. XDS uses existing ‘open’ IT standards (http and ebXML – an OASIS and ISO standard) to share stored electronic documents, and therefore to enable development of wide-area electronic healthcare records. XDS helps to address the interoperability problems inherent in sharing electronic healthcare records between different IT systems and is rapidly being adopted around the world with ongoing national programs in Austria, Italy, USA, Canada, France and also several regional projects.

Potential Project

A potential project would be to setup a regional XDS implementation and involve as many health organisations as are willing to share information.